S! 

o 


tt 

'S 

o 

T> 


ff\ 

* 

"1 

£ 

rt 

* 

*ST 

I 


* 

fa 

C- 

-n 

* 

£ 

1 

*tJ 

* 

tr\ 


*S> 

<sv 


OCTOBER,  1906 


BULLETIN 


OF  THE 


State  College  of  Kentucky 


LEXINGTON,  KY. 


UNIVERSITY  OP  if  f 


PRESIDENT'S  OFfJC 


FROM  THE 


Laboratory  of  Anatomy  and  Physiology 


PUBLISHED  BY  THE  COLLEGE 


August  9,  1902,  at  Lexington,  Kentucky,  as  second  class  matter,  under  Act  of  Congress,  July  16,  1894 


I 


1 


OSSIFICATION 


oyr 


OF  THE 


Epiphyses  of  the  Hand. 

X-RAY  METHOD. 


BY 

J.  W.  PRYOR,  M.  D. 

Professor  of  Anatomy  and  Physiology,  State  College 
of  Kentucky,  Lexingion,  Kentucky 


LEXINGTON,  KY. 

PRESS  OF  TRANSYLVANIA  COMPANY 
1906 


FIG.  I.  M.  B.,  FEMALE,  AGE  1 YEAR,  2 MONTHS,  20  DAYS.  1st  CHILD. 


THE  OSSIFICATION  OF  THE 
EPIPHYSES  OF  THE  HAND 


The  Epiphyses  of  the  hand  are  all  cartilaginous  at  birth.  The  diaphyses  are 
well  advanced  in  ossification,  having  commenced  this  process  “about  the  eighth 
week  of  intra-nterine  life.” 

The  first  point  of  ossification  to  appear,  of  the  epiphyses,  is  that  of  the  lower 
extremity  of  the  radius.  While  the  lower  extremity  of  the  radios  and  the  olna  are 
not  a part  of  the  hand,  I think  the  development  of  these  epiphyses  should  he  con- 
sidered in  connection  with  the  development  of  the  hand. 

In  the  hand  of  the  female  a point  of  ossification  may  appear,  in  the  epiphysis, 
of  the  lower  extremity  of  the  radios,  as  early  as  two  or  three  months  after  birth. 

This  we  see  in  the  hand  of  M.  B.  female,  age  one  year,  two  months  and  twenty 
days  (Fig.  I).  I will  here  call  attention  to  all  of  the  illustrations  given,  the  young- 
est of  which  indicates  an  early  ossification  of  this  epiphysis.  In  every  hand  of  the 
female  I have  seen,  the  size  of  the  nucleus  would  indicate  its  appearance  before 
the  close  of  the  first  year,  and  in  the  majority  about  the  eighth  month.  This 
epiphysis  will  unite  with  the  shaft  between  the  seventeenth  and  twentieth  years. 
In  the  majority  of  instances  it  will  unite  about  the  twentieth  year.  It  appears 
earlier  than  that  of  the  ulna,  but  is  later  in  uniting  with  the  shaft. 

In  the  hand  of  the  male  the  epiphysis  of  the  lower  extremity  of  the  radius  is  a 
few  months  later  in  developing.  The  hand  of  P.  M.  male,  age  ten  months  and  seven 
days,  does  not  show  any  evidence  of  ossification  of  this  epiphysis.  A negative  of 
the  same  hand  taken  a few  months  later,  i.  e.,  at  the  age  of  one  year,  six  months, 
and  six  days,  (Fig.  IX.),  shows  an  oblong  nucleus,  five  m.  m.  in  width  and  two  m.  m. 
in  thickness,  indicating  its  appearance  soon  after  the  close  of  the  first  year. 


FIG.  II.  M.  B.,  FEMALE,  AGE  2 YEARS,  3 MONTHS,  10  DAYS.  1st  CHILD 


PIG.  III.  M.  B.,  FEMALE,  AGE  3 YEARS,  2 MONTHS,  9 DAYS.  1st  CHILD 


This  is  a fifth  child  of  his  parents  and  would  he  somewhat  slower  in  developing, 
in  every  hand  of  the  male,  that  I have  examined,  a point  of  ossification  had  appeared 
in  the  epiphysis  of  the  lower  extremity  of  the  radius  before  the  child  was  two  years 
of  age. 

T think  in  a majority  of  the  cases  this  epiphysis  will  begin  to  ossify  in  the  hand 
of  the  male  early  in  the  second  year,  that  is  about  the  fifteenth  month.  This  epi- 
physis will  unite  with  the  shaft  about  the  twenty-first  year.  Like  the  hand  of  the 
female,  it  appears  before  that  of  the  ulna,  but  is  later  uniting  with  the  shaft. 

A point  of  ossification  of  the  epiphysis  of  the  lower  extremity  of  the  ulna , 
of  the  hand  of  the  female,  may  appear  before  the  end  of  the  fifth  year.  The  young- 
est hand  I have  seen  in  which  this  epiphysis  had  appeared  was  at  the  age  of  four 
years  and  six  months.  1 have  observed  a few  when  between  five  and  six  years  of  age. 
At  least  ninety  per  cent,  will  not  appear  until  the  child  is  six  years  of  age,  and  be- 
tween that  and  seven.  Although  this  epiphysis  appears  four  or  five  years  after  that 
of  the  radius,  it  unites  with  the  shaft  before  it.  It  unites  with  the  shaft  about  the 
eighteenth  year,  sometimes  several  years  sooner. 

In  the  hand  of  the  male,  the  earliest  appearance  of  the  epiphysis  of  the  lower 
extremity  of  the  ulna,  was  at  the  age  of  five  years  and  four  months.  Very  few  ap- 
peared before  the  child  was  seven  years  of  age,  and  the  majority  between  seven  and 
eight  years  old.  In  the  hand  of  the  male,  this  epiphysis  will  unite  with  the  shaft 
about  the  nineteenth  or  twentieth  year. 

In  regard  to  the  ossification  of  the  epiphyses  of  the  hand,  Cunningham1 
says : “The  secondary  centers  from  which  the  heads  of  the  second,  third,  fourth, 
and  fifth  metacarpal s and  the  base  of  the  first  are  developed  appear  about  the  third 
year  and  usually  completely  fuse  with  the  shaft  about  the  age  of  twenty.  There 

may  he  an  independent  center  for  the  Styloid  process  of  the  third  metacarpal.  The 
phalanges  are  ossified  from  primary  and  secondary  centers.  From  the  former, 

which  appear  as  early  as  the  ninth  week  of  foetal  life,  the  shaft  and  distal  ex- 
tremities are  developed  ; whilst  the  latter,  which  begin  to  appear  about  the  third 

l Text  Book  of  Anatomy,  Cunningham,  pages  212,  213. 


FIG.  IV.  C.  G.  B„  FEMALE.  AGE  1 YEAR,  9 MONTHS,  24  DAYS.  1st  CHILD 


s 


year,  form  the  proximal  epiphyses,  which  unite  with  the  shaft  from  eighteen  to 
twenty.” 

I quote  from  Morris2  as  follows : “Each  of  the  metacarpal  hones  and  pha- 
langes are  ossified  from  a primary  center  for  the  greater  part  of  the  hone  and  from 
one  epiphyseal  center.  The  primary  nucleus  appears  from  the  eighth  to  the  tenth 
week  of  intra-uterine  life.  In  the  inner  four  metacarpal  hones  the  epiphysis  is 
distal,  whilst  in  the  first  metacarpal  hone,  and  in  all  the  phalanges  it  is  proximal. 
The  epiphyseal  nuclei  appear  from  the  third  to  the  fifth  year  and  are  united  to 
their  respective  shafts  about  the  twentieth  year.  The  third  metacarpal  occasionally 
has  an  additional  nucleus  for  the  prominent  Styloid  process,  which  may  remain 
distinct  and  form  a Styloid  bone,  and  traces  of  a proximal  epiphysis  have  been  ob- 
served in  the  second  metacarpal  bone.” 

Holden3  gives  the  following:  “Each  metacarpal  bone  has  a center  of  ossifica- 
tion for  the  shaft  and  proximal  end,  which  appears  near  the  distal  end  about  the 
eighth  week  of  foetal  life.  Each  also  has  an  epiphysis  at  its  distal  end,  of  which 
the  nucleus  appears  from  about  the  third  to  the  fifth  year.  The  metacarpal  bone  of 
the  thumb,  however,  has  its  epiphysis  at  the  proximal  end,  like  the  phalanges  of 
the  fingers.  All  unite  to  the  shaft  about  the  nineteenth  year.  Each  phalanx  has 
two  centers  of  ossification  : one  for  the  shaft  and  distal  end,  appearing  about  the 
eighth  week;  the  other  for  the  proximal  end,  appearing  from  the  third  to  the  fifth 
year,  and  remaining  an  epiphysis  till  about  the  twentieth  year." 

Gray4  says:  “The  metacarpal  bones  are  each  developed  by  two  centers,  one 
for  the  shaft  and  one  for  the  distal  extremity,  for  the  four  inner  metacarpal  bones, 
one  for  the  shaft  and  one  for  the  base,  for  the  metacarpal  bone  of  the  thumb,  which 
in  this  respect  resembles  the  phalanges.  About  the  third  year  the  digital  extremities 
of  the  four  inner  metacarpal  bones  and  the  base  of  the  first  metacarpal  begins  to 
ossify  and  they  unite  about  the  twentieth  year. 

“The  phalanges  are  each  developed  by  two  centers  ; one  for  the  shaft  and  one 

2 Human  Anatomy,  Morris,  page  152. 

3 Human  Osteology,  Holden,  pages  3 35-33  8. 

4 Gray’s  anatomy,  pages  205,  206. 


FIG.  V.  D.  D„  FEMALE,  AGE  2 YEARS,  2 MONTHS,  23  DAYS.  4th  CHILD. 


10 


for  the  base.  Ossification  of  the  base  commences  in  the  first  row  between  the  third 
and  fourth  years,  and  a year  later  in  those  of  the  second  and  third  row.  The  two 
centers  become  united  in  each  row,  between  the  eighteenth  and  twentieth  years.” 

Poland5  differs  but  little  from  the  others  quoted,  he  says:  “The  epiphysis 
of  the  metacarpal  hone  of  the  thumb  is  developed  like  one  of  the  phalanges,  the 
epiphysis  being  situated  at  its  prixomal  end.  In  the  four  inner  or  true  metacarpals 
the  epiphysis  is  placed  at  the  lower  extremity.  Both  morphologically  and  develop- 
mental^ this  bone  should  be  regarded  as  a phalanx.  The  epiphyses  hitherto  car- 
tilaginous in  all  the  metacarpal  bones  begin  to  ossify  about  the  third  and  unite  with 
the  shaft  about  the  nineteenth  year.  Ossification  takes  place  successively  from  the 
first  phalanges  to  the  second,  and  lastly  in  the  third,  in  the  first  row  from  the  third 
to  the  fourth  year  and  on  the  second  and  third  row  from  the  fourth  to  the  fifth 
year.  The  epiphysis  of  the  terminal  phalanx  of  the  little  finger  is  frequently  ab- 
sent, the  epiphyses  unite  to  their  respective  shafts  about  the  nineteenth  year.” 

My  observations  differ  very  materially  from  the  above,  quoted  from  the  latest 
editions  of  these  standard  works. 

There  is  no  distinction  made  by  any  of  these  authors  between  the  hand  of  the 
male  and  that  of  the  female,  and  yet  there  can  be  no  question  that  the  hand  of  the 
female  developes  much  sooner  than  that  of  the  male.  As  1 have  said  before,  this 
is  first  measured  by  days,  then  months,  then  years.  The  fully  developed  hand  of 
the  female  being  at  least  two  years  in  advance  of  that  of  the  male.  Whilst  the  indi- 
vidual skiagrams  show  this  difference  in  the  development  of  the  hand  of  the  female 
in  advance  of  that  of  the  male,  the  contrast  is  more  distinctly  and  picturesquely 
shown  in  twins  of  the  same  sex  and  those  of  different  sexes. 

In  the  hands  of  twins  of  the  same  sex  (Figs.  XYI.  and  XV LI.),  Beula  S. 
and  Bertha  S.,  female,  age  six  years,  seven  months,  and  seven  days— eighth  children 
of  parents — we  see  a duplicate  development.  With  the  exception  of  the  nucleus  of 
the  lower  extremity  of  the  ulna  these  two  hands  are  as  much  alike  as  two  peas  in  a 
pod.  Xot  so  with  Figs.  XYI  1 1.  and  XIX.,  Frmie  K.,  male,  and  Erna  K.,  female, 
age  five  years,  one  month,  and  twelve  days,  first  children  of  parents.  The  hand  of 
5 Skiagraphic  Atlas,  Poland,  pages,  5,  6. 


FIG.  VI.  C.  I).,  FEMALE,  AGE  4 YEAKS,  8 MONTHS.  18  DAYS.  3d  CHILD. 


the  girl  is  decidedly  in  advance  ol  the  hov.  V hilst  this  is  evidenced  by  the  epiphyses, 
the  hones  of  tlie  carpus;  in  which  we  see  three  hones,  i.  c..  the  trapezium,  trapezoid, 
and  the  scaphoid,  present  in  the  hand  of  the  female  that  have  not  appeared  in  the 
hand  of  the  male ; gives  us  the  hest  evidence  ol  the  hand  of  the  female  developing 
in  advance  of  that  of  the  male.  There  are  no  exceptions  to  this  rule. 

The  second  epiphysis  to  appear  in  the  hand  of  the  female  is  that  of  the  prox- 
imal extremity,  of  the  first  phalanx  of  the  middle  finger,  followed  by  the  ring, 
index,  and  little  fingers,  then  the  thumb.  The  first  named  may  appear  as  early  as 
the  sixth  month,  as  seen  in  the  hand  of  M.  B.  female,  age  one  year,  two  months, 
and  twenty  days  (Fig.  I.).  The  size  of  this  nucleus  would  indicate  eight  to  ten 
months'  growth.  Another  exposure  of  this  hand  was  made  at  the  age  of  two  years, 
three  months,  and  ten  days  (Fig.  IF),  which  shows  two  new  centers,  that  of  the 
first  phalanx  of  the  thumb  and  that  of  the  second  phalanx  of  the  little  finger.  These 
I have  noticed  in  a number  of  instances  develope  synchronously.  This  mav  he  a 
coincidence.  I shall  endeavor  to  determine,  sometime  in  the  future,  if  they  hear 
an  anatomical  relationship.  Another  exposure  of  this  hand  was  made  at  the  age  of 
three  years,  two  months,  and  nine  days  (Fig.  Ill),  in  which  we  have  all  the  epi- 
physes. The  last  to  appear  is  that  of  the  ungual  phalanx  of  the  little  finger.  All 
have  appeared  before  the  child  was  three  years  of  age. 

This  is  not  an  exceptional  hand,  as  will  be  seen  when  compared  with  Fig. 
IV.,  C.  (t.  B.,  female,  age  one  year,  nine  months,  and  twenty-four  days.  In  this 
hand  all  the  epiphyses  have  appeared.  The  size  of  the  epiphyses  of  the  first  row  of 
phalanges  and  those  of  the  metacarpal  hones,  and  the  form  they  are  assuming, 
would  indicate  something  of  the  time  of  their  appearance.  The  first  named,  ap- 
pearing as  early  as  the  sixth  or  eighth  month,  and  all,  with  the  exception  of  those 
of  the  metacarpal  hone  of  the  thumb,  have  made  their  appearance  before  the  close 
of  the  fifteenth  month.  That  of  the  second  metacarpal  bone  appeared  synchronous 
with  or  soon  after  that  of*  the  first  phalanx  of  the  middle  finger,  i.  e.,  between  the 
sixth  and  eighth  month,  followed  bv  the  third,  fourth,  fifth,  and  lastly  the  first  or 
metacarpal  bone  of  the  thumb,  in  which  we  see  a minute  point  of  ossification,  ap- 
pearing in  the  twenty-second  month  or  late  in  the  second  year.  The  epiphyses  of 
the  second  row  of  phalanges,  beginning  with  the  middle  finger,  began  to  ossify  late 


FIG.  VII.  E.  C.,  FEMALE,  AGE  2 YEAES,  5 MONTHS,  13  DAYS.  2d  CHILD 


in  the  first  year.  This  was  followed  by  the  ring,  the  index,  and  little  finger.  All 
must  have  appeared  before  the  close  of  the  fifteenth  month.  The  ungual  epiphyses 
are  all  present.  That  of  the  thumb  appearing  first,  having  commenced  to  ossify 
as  soon  as  the  tenth  month.  The  thumb  is  followed  by  the  middle  finger,  then  the 
ring  finger,  the  index  finger  and  lastly  by  the  little  finger,  in  which  we  see  a small 
point  of  ossification,  making  its  appearance  in  the  twenty-second  month.  In  this 
hand  we  have  an  instance  in  which  all  of  the  epiphyses  have  appeared  before  the 
child  was  two  years  of  age.  In  some  respects  this  hand  is  far  in  advance  of  the  one 
just  described,  and  in  some  respects  it  presents  a slower  development.  Note  the 
cuneiform  in  the  former  and  its  absence  in  the  latter. 

We  will  next  consider  the  hand  of  D.  D.,  female,  age  two  years,  two  months, 
and  twenty-three  days,  fourth  child  of  parents  (Fig.  V.).  This  child  is  but  a few 
months  over  two  years  of  age  and  all  of  the  epiphyses  have  appeared.  That  of  the 
ungual  phalanx  of  the  little  finger  is  a minute  point,  but  is  distinct  in  both  hands. 
All  of  the  other  epiphyses  are  well  advanced  in  ossification.  In  some  respects  this 
hand  is  in  advance  of  either  of  the  two  previously  described.  Note  the  size  of  the 
nuclei  of  the  metacarpal  epiphyses  and  those  of  the  magnum,  unciform  and  cunei- 
form bones.  The  sister  of  this  child  (Fig.  VI.),  C.  D.,  age  four  years,  eight  months, 
and  eighteen  days,  is  given  for  the  sake  of  comparison.  The  advanced  state  of 
ossification  of  all  of  the  epiphyses  in  this  hand  shows  that  this  process  had  com- 
menced fully  as  soon  as  that  of  the  sister  two  years  and  six  months  younger.  All 
of  these  epiphyses  had  commenced  to  ossify  before  the  child  was  two  and  one-half 
years  of  age.  I will  also  call  attention  to  the  chronological  development  of  the 
bones  of  the  carpus,  in  which  we  find  the  trapezoid  preceding  the  scaphoid.  The 
younger  sister  has  not  reached  the  age  when  these  should  appear.  However,  I 
expect  to  find  her  hand  developing  in  the  same  order. 

The  next  illustration  is  that  of  E.  C.,  female,  age  two  years,  five  months,  and 
thirteen  days,  second  child  of  parents  (Fig.  VII.).  All  of  the  epiphyses  of  this 
hand  have  commenced  ossification  except  that  of  the  first  phalanx  of  the  thumb, 
the  second  phalanx  of  the  little  finger  (you  will  see  the  similarity  concerning  these 
two),  and  the  ungual  phalanges  of  the  index  and  little  fingers.  The  ossification 


FIG.  VIII.  E.  W.,  FEMALE,  AGE  2 YEARS,  li  MONTHS 


2d  CHILI) 


5th  CHILD. 


FIG.  IX.  P.  M.,  MALE,  AGE  I YEAli.  (i  MONTHS,  6 DAYS. 


PIG.  X.  P.  M..  MALE,  AGE  1 YEAR,  11  MONTHS,  11  DAYS. 


5th  CHILD. 


18 


of  the  epiphyses  of  this  hand  is  similar  to  those  described.  All  of  the  nuclei  will 
have  appeared  before  the  child  is  three  years  of  age. 

The  last  illustration  T will  give  showing  the  ossification  of  the  epiphyses  of 
the  hand  of  the  female  is  that  of  E.  W.,  age  two  years  and  eleven  months,  second 
child  of  parents  (Fig.  A TT!.).  This  is  a precocious  hand  and  in  every  respect 
much  in  advance  of  the  others,  and,  of  course,  is  in  advance  of  the  average.  This 
is.  a poor  negative,  showing  considerable  motion,  but  T could  not  forego  presenting 
it  as  one  of  these  illustrations.  The  most  of  the  epiphyses  are  distinct  and  the 
nuclei  quite  large.  Five  of  the  carpal  bones  are  developing  rapidly. 

After  a careful  investigation  of  these  and  a number  of  other  hands  of  females 
three  years  of  age  and  younger,  T have  thought  the  average  hand  of  the  female 
would  develope  in  the  following  order:  The  epiphysis  of  the  first  phalanx  of  the 
middle  finger  will  show  the  first  point  of  ossification  before  the  close  of  the  first 
year.  This  will  be  followed  by  the  ring  and  index,  then  the  little  finger.  All  will 
have  appeared  by  the  close  of  the  fifteenth  month.  Synchronous  with,  or  immedi- 
ately after  this,  the  epiphyses  of  the  distal  extremities  of  the  metacarpal  bones  will 
appear  in  the  following  order:  The  first  to  appear  is  that  of  the  index  finger,  then 
the  middle,  then  the  ring,  then  the  little  finger,  and  lastly  the  thumb.  That  of 
the  index  finger  will  make  its  appearance  before  the  close  of  the  first  year.  All 
will  have  appeared  by  the  fifteenth  month,  except  that  of  the  thumb,  which  usually 
does  not  commence  to  ossify  until  the  child  is  over  two  years  of  age.  The  epiphyses 
of  the  second  row  of  phalanges  appear  in  the  same  order  as  those  of  the  first  row, 
i.  e.,  middle , ring,  index,  little  fingers  successively.  The  first  named  appears  about 
the  close  of  the  first  year.  All  are  usually  present  before  the  child  is  two  years  of 
age.  The  epiphysis  of  the  first  phalanx  of  the  thumb  appears  synchronous  with 
that  of  the  second  phalanx  of  the  little  finger  before  the  close  of  the  second  year. 

The  last  row  of  phalanges  or  ungual  phalanges  appear  in  the  following  order: 
The  first  point  to  appear  is  in  the  thumb,  followed  by  the  middle,  ring,  index  and 
little  fingers.  The  first  named  will  appear  early  in  the  second  year  or  between  the 
fifteenth  and  twentieth  month.  That  of  the  middle  fiuger  will  appear  soon  after 
the  thumb.  All  will  have  made  their  appearance  before  the  close  of  the  third  year 
or  by  the  time  the  child  is  three  years  of  age. 


FIG.  XI.  W.  S.,  MALE,  AGE  1 YEAR,  9 MONTHS,  10  DAYS.  1st  CHILD. 


In  illustrating  the  ossification  of  the  epiphyses  in  the  hand  of  the  male,  the 
youngest,  hand  1 have  showing  points  of  ossification  in  these  epiphyses  is  that  of 
P.  M.,  age  one  year,  six  months,  and  six  days  (Fig.  IX.).  This  is  a fifth  child  of 
parents  and  is  somewhat  slower  in  development  than  the  first  or  second  children. 
As  in  the  hand  of  the  female,  the  first  epiphysis  to  appear  is  that  of  the  lower  ex- 
tremity of  the  radius.  The  nucleus  is  5x2  m.  m.  This  evidently  appeared  soon 
after  the  close  of  the  first  year.  In  this  hand  the  second  epiphyses  to  begin  the 
process  of  ossification  is  a proximal  epipsysis  to  the  second  metacarpal  hone.  I 
would  judge  this  made  its  appearance  at  the  close  of  the  first  year. 

I have  observed  this  extra  epiphysis  in  the  hands  of  hut  six  families  out  of 
over  two  hundred  families.  It  is  therefore  not  of  common  occurrence,  but  is  com- 
paratively rare,  and  only  occurs  as  a family  characteristic-.  1 can  state  this  positively . 
It  unites  very  soon  with  the  shaft,  sometimes  before  the  fourth  year,  usually  by 
the  sixth  or  seventh  year,  although  the  union  may  he  delayed  until  the  fourteenth 
year.  As  it  sometimes  unites  with  the  shaft  so  early,  it  is  possible  I may  have  a 
number  of  hands  in  which  the  epiphyseal  line  is  completely  obliterated,  and  it  may 
occur  with  more  frequency  than  my  observations  would  indicate. 

In  this  hand  the  next  epiphysis  to  appear  was  that  of  the  middle  finger  of  the 
first  row  of  phalanges,  followed  by  the  ring  and  index  fingers.  That  of  the  little 
finger  has  not  appeared  I would  judge,  these  made  their  appearance  about  the 
fifteenth  month.  There  is  a minute  point  of  ossification  in  the  ungual  phalanx 
of  the  thumb  appearing  in  the  eighteenth  month. 

Another  exposure,  of  this  hand,  was  made  at  the  age  of  one  year,  eleven 
months,  and  six  days,  that  is,  five  months  following  the  last  (Fig.  X.).  All  the 
epiphyses  present  at  the  previous  sitting  have  increased  in  size.  You  will  see  the 
nucleus  of  the  proximal  epiphysis  of  the  second  metacarpal  has  increased  in  size  and 
is  rapidly  uniting  with  the  shaft.  The  new  points  of  ossification  to  be  seen  are, 
the  distal  epiphyses  of  the  second  and  third  metacarpals,  and  those  of  the  second 
row  of  phalanges,  beginning  with  the  middle  finger,  then  the  ring  finger,  all  ap- 
pearing before  the  close  of  the  second  year. 

In  this  hand  (Fig.  IX.)  we  find  the  first  appearance  of  a scale-like  epiphysis, 
sometimes  present  at  the  distal  extremity  of  the  first  metacarpal. 


FIG.  XII.  G. 


G.. 


MALE,  AGE  3 YEARS,  5 DAYS. 


FIRST  CHILD. 


22 


Cunningham6  says  of  this  epiphysis:  “There  is  usually  a scale-like  epiphysis 
on  the  head  of  the  first  metacarpal,  which  makes  its  appearance  about  eight  or  ten, 
and  rapidly  unites  with  the  head.” 

Morris7  says  : “In  many  cases  the  first  metacarpal  has  two  epiphyses,  one  for 
the  base  in  the  third  and  an  additional  one  for  the  head  in  the  seventh  year,  but 
the  latter  is  never  so  large  as  in  the  other  metacarpal  hones.” 

Poland8  says : “Traces  of  a distal  epiphysis  in  the  metacarpal  bone  of  the 
thumb  are  usually  to  be  seen,  and  in  some  instances  a distinct  epiphysis  (as  in  the 
Seal  and  some  other  animals)  is  visible  at  the  age  of  seven  or  eight  years.” 

Holden9  says : “Very  often  there  is  a distal  epiphysis  appearing  in  the  meta- 
carpal of  the  thumb  about  the  eighth  year  and  an  epiphysis  at  the  proximal  end  of 
the  second  metacarpal  about  the  same  time.” 

My  observations  are  quite  different  from  those  quoted.  I have  found  this 
epiphysis  present  in  about  six  per  cent,  of  the  cases.  It  is  possible  it  occurs  with 
greater  frequency,  as  it  unites  with  the  head  of  the  bone  very  rapidly  and  could  be 
overlooked,  and  the  epiphyseal  line  is  soon  obliterated.  Like  other  variations  in  the 
ossification  of  bones  it  is  a family  cl i a met  eristic  and  will  be  found  in  the  hands  of 
the  brothers  and  sisters.  I have  been  fortunate  in  having  the  opportunity  to  present 
the  first  appearance  of  this  epiphysis  in  one  hand  at  least  (Fig.  IX.).  You  will 
see  a small  elevation  on  the  distal  extremity  of  the  metacarpal  bone  of  the  thumb; 
this  I am  sure  is  a separate  point  of  ossification.  In  the  exposure  of  this  hand, 
made  six  months  later  (Fig.  X.),  this  epiphysis  lias  flattened  and  increased  in  size. 
The  epiphyseal  line  is  not  distinct. 

The  shape  of  this  epiphysis  is  quite  different  from  others  in  the  hand.  The 
head  of  the  metacarpal  bone  is  slightly  hollowed.  The  epiphysis  becomes,  as  it  is 
increased  in  size,  convex  on  the  upper  surface  and  concave  beneath,  thicker  in  the 
center  and  very  thin  at  the  periphery.  It  thus  fills  the  cavity  in  the  upper  ex- 
tremity of  the  shaft  and  forms  the  rounded  head  of  the  bone. 

This  cannot  be  seen  in  the  print;  we  can  always  see  a great  deal  of  detail  in 

6 Text  Book  of  Anatomy,  Cunningham,  page  212. 

7 Human  Anatomy,  Morris,  page  152. 

8 Skiagraphic  Atlas,  Poland,  page  58. 

9 Human  Osteology,  Holden,  page  3 3 5. 


FIG.  XIII.  B.  P.,  MALE,  AGE  3 YEABS.  EIGHTH  CHILD 


the  negative  that  is  lost  in  the  print,  and  there  is  still  greater  loss  in  the  half-tone. 
However,  in  the  older  hands  we  have  an  opportunity  of  a distinct  view  of  this 
epiphysis.  The  older  brother,  G.  M.,  age  six  years  and  one  month  (Fig.  XX.), 
gives  a splendid  example  of  this  epiphysis.  The  epiphyseal  line  is  distinct,  whilst 
in  the  hand  of  the  sister,  age  eight  years  and  one  month,  the  line  is  almost  oblit- 
erated. and  in  the  hand  of  the  still  older  sister,  age  ten  years,  the  line  is  completely 
obliterated  and  it  would  he  impossible  to  tell  there  had  ever  been  an  epiphysis  at 
this  point.  Having  satisfied  myself  this  is  a biological  law  without  exception,  I 
know  this  epiphysis  was  present  in  the  last  hand  as  well  as  in  the  hands  of  the  other 
brothers  and  sisters. 

The  oldest  hand  in  which  I can  positively  trace  this  epiphysis  is  about  eight 
years  of  age,  that  is  in  which  the  epiphyseal  line  is  not  obliterated.  The  size  of 
the  nuclei  in  all  of  my  negatives  would  indicate  its  appearance  before  the  child 
was  four  years  of  age,  and  sometimes  much  sooner,  as  in  the  instance  I have  given 
in  which  it  made  its  appearance  about  the  seventeenth  month. 

In  place  of  making  its  appearance  at  the  eighth  year,  my  observations  indicate 
its  disappearance  at  that  age. 

I have  examined  over  two  hundred  negatives  of  hands  four  years  old  and  older 
without  the  slightest  evidence  of  an  epiphysis  appearing  at  this  point  after  the  child 
has  become  four  years  of  age.  I am  sure  it  never  appears  as  late  as  the  eighth  year. 

The  hand  of  W.  S.,  male,  age  one  year,  nine  months,  and  ten  days  (Fig.  XI.), 
is  developing  in  the  sme  order  as  the  one  described,  but  shows  more  points  of  ossi- 
fication than  the  other  would  have  shown  at  the  same  age.  This  is  the  first  child  of 
parents.  In  this  hand  the  nucleus  of  the  epiphysis  of  the  lower  extremity  of  the 
radius  is  6x3  m.  m.  This  began  to  ossify  before  the  close  of  the  first  year.  The 
second  point  to  appear  is  that  of  the  middle  finger,  first  row  of  the  phalanges,  fol- 
lowed by  the  ring  and  index  fingers,  and  there  is  a minute  point  starting  in  the 
little  finger.  The  epiphysis  of  the  second  metacarpal  commenced  ossification  simul- 
taneous with  or  a short  time  before  that  of  the  first  phalanx  of  the  middle  finger. 
This  is  followed  by  the  third  and  fourth  metacarpals,  and  there  is  a good  sized 
point  in  the  ungual  phalanx  of  the  thumb.  The  first  of  these  must  have  com- 
menced the  process  of  ossification  by  the  fifteenth  month.  There  is  every  reason 


FIG.  XIV.  J.  D.  0.,  MALE,  AGE  4 YEARS,  1 MONTH,  17  DAYS.  1st  CHILD. 


26 


to  believe  that  the  other  epiphyses  will  appear  rapidly  in  this  hand.  You  will  note 
a.  good  sized  nucleus  of  the  cuneiform  which  has  appeared  soon  after  the  close  of 
the  first  year.  In  the  next  hand,  that  of  G.  G.,  male,  age  three  years  and  five  days 
(Fig.  XII.)  the  development  is  somewhat  slower  than  the  average.  The  nucleus 
of  the  epiphysis  of  the  lower  extremity  of  the  radius  is  small  and  all  of  the  epi- 
physes have  appeared  late,  perhaps  very  late  in  the  second,  and  continued  through 
the  third  year.  Only  a small  point  has  appeared  in  the  ungual  phalanx  of  the 
middle  finger  and  a number  of  the  epiphyses  have  not  made  their  appearance. 

This  hand  affords  another  instance  of  a proximal  epiphysis  in  the  second 
metacarpal.  The  head  of  the  first  metacarpal  shows  evidence  of  a scale-like 
epiphysis. 

The  next  illustration  (Fig.  XIII.)  presents  an  instance  of  unusual  develop- 
ment. I».  P.,  male,  age  three  years,  eighth  child  of  parents.  All  of  the  epiphyses 
have  appeared  in  this  hand,  and  are  advanced  in  ossification.  Compare  this  hand 
with  the  next  (Fig.  XIV.),  J.  D.  0.,  age  four  years,  one  month,  and  seventeen 
days.  This  hand  presents  the  slowest  development  of  any  that  has  come  under 
my  observation. 

The  last  illustration  I will  give  represents  the  typical  development  of  the 
male  hand  (Fig.  XV.)  A.  F..  age  three  years,  ten  months,  and  twenty  days,  second 
child  of  parents;  All  of  the  epiphyses  are  advanced  in  ossification,  those  of  the 
first  row  of  the  phalanges  and  those  of  the  four  inner  metacarpal  bones  must  have 
appeared  early  in  the  sc(ond  gear.  All  appeared  before  the  close  of  the  third  year, 
or  before  the  child  was  three  years  of  age.  After  a careful  examination  of  a num- 
ber of  other  hands,  both  male  and  female,  four  years  of  age  and  younger,  I am  en- 
abled to  at  least  approximate  the  chronological  development  of  the  epiphyses,  as 
given  in  the  annexed  table. 

I am  not  prepared  to  state  when  the  epiphyses  of  the  metacarpals  and  pha- 
langes will  unite  with  the  shaft. 

I have  one  negative  of  a hand  of  a female  in  which  the  epiphyseal  line  was  com- 
pletely obliterated  at  fourteen  and  quite  a number  showing  perfect  fusion  between 
fifteen  and  sixteen  years  of  age. 

I shall  endeavor  to  determine  the  time  of  union  of  these  epiphyses  with  the 
shaft  some  time  in  the  future. 


PIG.  XV.  A.  F.,  MALE,  AGE  3 YEABS,  10  MONTHS,  20  DAYS.  2d  CHILD. 


FIG. 


XVI 


BETJLA  S.,  TWIN 
7 DAYS. 


FEMALE,  AGE  (i  YEARS. 
EIGHTH  CHILD. 


MONTHS, 


ry 

( 


FIG.  XVII.  BERTHA  S„  TWIX 

7 DAYS. 


FEMALE,  AGE  (i  YEARS, 
X'IXTH  CHILI). 


MONTHS, 


FIG  XVIII.  ERMIE  K.,  TWIN  MALE,  AGE  5 YEARS,  1 MONTH, 

12  DAYS.  FIRST  CHILD. 


FIG.  XIX.  ERNA  K.,  TWIN  FEMALE,  AGE  5 YEARS,  1 MONTH 

12  DAYS.  SECOND  CHILD. 


FIG.  XX.  G.  M.,  MALE,  AGE  6 TEALS,  1 MOXTH.  FOURTH  CHILD. 


CHRONOLOGICAL  TABLE 


03 

O 

Jh 

Pi 

fa 


.p  s 03  «3  £ 
« c5  . ® * e3 

© © s-  >.  h--  © 

>j  ki  ® -g  'C  ''' 

fafa  >■%  5^ 


& 

fa 

fi 


03  •- 
© 03 
>.  © 
— • P-i 


03  •_ 
® 03 
H.  © 


a.  £ 


© o 

© C/3  © 
& c/3 


oo  a 
© © 
r-i  r-i 

'C  T3 

/-"• 

■ o o 

© © 

CO  CO 


85  03 

© a> 
>.  >■ 
£'35 'C 

o o 

o © 
© © 
CO  CO 


03  5-1  03  . • sJ  03  © s;  „•  5-  , fl3  5m  '— 

•_pc3^p-.,?J03^pc;-^e;03 

03  r'i<r  ® S "*1,  '"•©  ^ 55  ''•a'  ^ 

® T3  K'"C  >j  >>  © £5  ''•’C  B.  t 'C  K''  ’"' 

C'O’g  £ _ -h  >■.  C 'w  r«  C "w  ^ 

■CCSO^SrCSO’-S'OOSC 
S;oc:.'h?3  3o“.hO'hOOO 
■h  a,  u ©5  J.H  !•  o i/rt  !■  o 

£5  CO  © CO  4_  £ CO  <©  rjr  ^ © “ " 

-t-J-HCO^-OJ^  — c«^,_co 


03  03 
© ® 


c3  e 
a-  £ 
>■  >. 
■C-C 


CO  © © , 
— CO  CO 


©Hh 

a-  *- 

CO  _ 


03  Cm 

© <- 

© 

15 

£ 15 

o c 
p c 

C (V) 
CO  2 
<—  co 


T a" 

03  c 


03  03  * 03  53 

fafafa  fa  fa 

fa^fa^fafafaHifas 


■fa  fa 


03  03 

fa  fa 


© © 
03  03 


<'•*“  *"*-  ' r'*  k-  k'.  -s 

•X'  ^ *7^  P • ^O'-p'thI'O'T^DC; 

cocSeso-oocoopoooocS^oSSccoo 
fa  fa  fa  fa  fa  fa  I— 1 fa 


03  03 

Kh 


03  03 

fafa 


. 

T.  ® 
= c 
Kh 


r HH  r HH  r HH  r H-  r HH  r H-  r HH  , H-l  r_  HM  r HH  r H-  r HH  r HH  r Hm 

JH  <0j  in  ^ pH  Hi  * HI  * Hi  fa  <3  fa  Hi  fa  ^ til  ^ fa  ^ fa  <<  i <*  J- 


25 

(—1 

fc 

25 


o 


Sh 

O 


0_  3m 


3 c 

— np 

Eh  El 


O o 

^ 5 


o 

E5 


o o c c 


X 

X 

X 

X 

X 

*"  co 

p X 

03 

C3 

03 

03 

03 

o> 

<p 

0^ 

0> 

Oh 

■'*' 

^ P 

Hi 

p% 

P*^ 

P. 

- — 

M 

ic 

iC 

LO 

iCT 

-3  ^ 

-2  "C 

c 

C 

o 

c 

c 

^ oc 

•4-H 

-4—* 

4— 

— . 

N? 

H*  3- 

^ r* 
0 ^ 

'M 

*M 

CM 

'M 

2 c: 

•Z  x 

x t: 

X W 
— 'M 

» 

Ui 

'— 

5^ 

o3 

03 

c3 

c3 

c3 

03 

03 

<D 

0) 

jp 

c 

X 

P 

P^i 

p^. 

P. 

HH. 

X 

X 

X 

X 

X 

. »-  '- 

%. 

— 

~ 

Ph 

• X 

03 

c3 

o3 

03 

03 

X a. 

Oh' 

<v 

Oh1 

0^ 

Q, 

r P*-. 

hH 

p^i 

p^i 

P^. 

P^. 

Hi 

a> 

0) 

~r  X 

Pi 

rK 

p 

P 

a 

p 

^ H' 

4— 

'i— 1 

4— 

M 1 

■ - 05 


N® 
..  03 


O - 


o - 


+-* 

o 

< 

<1 

<1 

<< 

<| 

hJ 

<1 

•J 

c3 

03 

03 

5 

c3 

o3 

03 

<P 

<x> 

a» 

<D 

a> 

P*> 

P*> 

P^H 

k. 

P". 

k. 

3D 

C~] 

^3 

,q 

1 • 

4— J 

4-1 

HH 

lO 

IO 

iQ 

to 

lO 

ire 

ic 

« 

o 

O 

o 

o 

o 

C 

C 

Pi 

4-2 

+-' 

4-> 

->H 

4-C 

4-> 

•w 

o 

73 

T3 

’C 

X3 

>73 

'O 

fc— H 

CO 

CO 

CO 

oo 

so 

CO 

CO 

q 

S3 

S 

H 

X 

po 

5 

5 

Q 

P4 

B 

S 

P 

H 

B 

pH 

J 

5 

rh 

M 

w 

Tfl 

M 

EH 

C 

fa 

BH 

s 

s 

03 

© 


eC 


Oh 

• M CO 

io 


o 

o 

Hi 


v 

Ha.ni\  >vxaK 
m 

w 

cc 

w 

a. 

I— C 

Qh 

J3 


© 

K»5 


o 


si 


X 

X 

X 

X 

X 

X 

X 

X 

cfi 

X 

%4 

>“H 

5^ 

— 

fa- 

s^ 

fa^ 

fan 

5m 

fan 

03 

o3 

03 

03 

03 

03 

03 

03 

03 

o3 

0) 

a> 

0^ 

P 

O 

a? 

P 

P 

© 

a> 

P^i 

P^H 

P^- 

P^ 

P% 

p^i 

P'. 

P. 

Bs 

P% 

a> 

a> 

0) 

<D 

<X> 

a> 

Oh 

c 

© 

<D 

O) 

<D 

CD 

P 

P 

0h 

P 

p 

© 

P 

o 

3 


■J.  as 

H‘  3 b 

Ml  C H *J 

3 

3 ~'C'C 

^ g « 5 

HH  © HM  4H 
M|hOn 

'■  I . 

! “ 53 
© © 

- — © © 
O o ' ^ 
^ © © 

_ H H 


©0 


»cc 

m 

GO 

fa* 

_ c 

.„C 

C 

03 

p 

• ^ 4_, 

/*  ^ 

X -rf 

^4 

>.  * 

Pig 

"P.g 

'd 

-§ 

O ^ 

_M  5" 

^ 0 

O ~ 

f5 

Hi  © 

O B 

0 

a 

-Hi  13 

th 

X 

CO  CO 

SO»5 

CO  CO 

q 

£t: 

fc 

,rH 

0 

O O 

p fl 

P*^ 

fan  C3 

s-  s 

c3 

fan 

, -1 

4H 

C 

x ^3 

C/3 

X TD 

— • 01 

— < CM 

-2- 

O 


O) 

CC 

• 03 

CD 

fa^ 

'P 

q 

CD 

•q 

o3 

© 

>» 


O 

o 

Hi 


© 

3D 


Hi 


^ © 

Xj  K% 

5 5 

© — 

: n ac 


•H 

03 

o3 

0/ 

0^ 

© 

V<4 

t>i 

P% 

fa4 

si 

q 

r-> 

03 

<D 

»co 

4-> 

ICO 

4-» 

LO 

P^4  p 

0 

0 

0 

T3 

4-> 

4-2 

CM 

'd 

T3 

CO 

CO 

CO 

fa  t 

M 

W 

q 

« 

X 

P 

w 

B 

s 

w 

p 

B 

p 

p 

ic 

HH 

K 

4 

M 

fa 

Eh 

/ 

fa  ! 

'IYHJ 

a d 

3D 

fa 

fa 

m 

3D 

>• 

fa 

fa 

fa 

fa 

h-( 

fa 

M 

Oh 

Jfa 

fa 

r 


I 


A 


2 105655424 


THE  Courses  of  Instruction  in  the  State  College  of  Kentucky 
are  comprised  in  five  departments,  viz.:  Science,  Classics, 
Normal,  Engineering,  Agriculture  and  the  Academy. 

In  Science  the  B.  S.  degree  is  conferred  in  courses  embracing 
Chemistry,  Zoology,  Geology,  Botany,  Physics,  Entomology  and 
Anatomy  and  Physiology.  In  Classics  the  B.  A.  degree  is  conferred 
in  courses  having  English  and  Latin  and  Greek  as  majors.  In  the 
Normal  Department  the  degree  of  B.  Ped.  The  Engineering  Depart- 
ment (Mechanical,  Electrical,  Civil  and  Mining)  offers  the  B.  M.  E., 
B.  C.  E.,  and  B.  E.  M.  degrees,  and  the  Department  of  Agriculture 
confers  the  degree  of  B.  S.  In  all  of  the  departments  the  Masters 
degree  is  conferred  under  conditions  requiring  actual  post  graduate 
work.  The  Academy  is  preparatory  to  entrance  in  the  College. 
Catalogues  of  description  will  be  mailed  on  application  to  the 
President  of  the  College  or  the  heads  of  departments. 


